Estimation of Breast Cancer Overdiagnosis in a U.S. Breast Screening Cohort
Authors: Charles Harding, Dmitriy Burmistrov, Marybeth Pompei, Francesco Pompei
Journal: Annals of Internal Medicine (2022)

LettersOctober 2022Estimation of Breast Cancer Overdiagnosis in a U.S. Breast Screening CohortCharles Harding, AB, Dmitriy Burmistrov, PhD, Marybeth Pompei, DPS, Francesco Pompei, PhDCharles Harding, ABSeattle, WashingtonSearch for more papers by this author, Dmitriy Burmistrov, PhDWoburn, MassachusettsSearch for more papers by this author, Marybeth Pompei, DPSExergen, Watertown, MassachusettsSearch for more papers by this author, Francesco Pompei, PhDExergen, Watertown, MassachusettsSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/L22-0274 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR: Ryser and colleagues' study (1) is admirable for its use of high-quality data from the Breast Cancer Surveillance Consortium, best Bayesian practices, and identifiability validation. However, it also depends on the improbable assumption that screening has equal sensitivity for indolent and progressive tumors.This assumption is not plausible because indolent tumors are typically smaller than progressive tumors and smaller tumors are harder to detect on a mammogram (2, 3). Indeed, indolent tumors are believed to be most common at the smallest sizes, where sensitivity is lowest. Ryser and colleagues assign 81% sensitivity to all tumors (indolent and ...References1. Ryser MD, Lange J, Inoue LYT, et al. Estimation of breast cancer overdiagnosis in a U.S. breast screening cohort. Ann Intern Med. 2022;175:471-78. [PMID: 35226520] doi:10.7326/M21-3577 LinkGoogle Scholar2. Weedon-Fekjaer H, Lindqvist BH, Vatten LJ, et al. Breast cancer tumor growth estimated through mammography screening data. Breast Cancer Res. 2008;10:R41. [PMID: 18466608] doi:10.1186/bcr2092 CrossrefMedlineGoogle Scholar3. Abrahamsson L, Isheden G, Czene K, et al. Continuous tumour growth models, lead time estimation and length bias in breast cancer screening studies. Stat Methods Med Res. 2020;29:374-95. [PMID: 30854935] doi:10.1177/0962280219832901 CrossrefMedlineGoogle Scholar4. Harding C. R script for simulation of breast cancer incidence in screened cohorts, with outputs. Figshare. 13 April 2022. Accessed at www.doi.org/10.6084/m9.figshare.19593319 on 21 April 2022. Google Scholar5. Harding C, Pompei F, Burmistrov D, et al. Long-term relationships between screening rates, breast cancer characteristics, and overdiagnosis in US counties, 1975-2009. Int J Cancer. 2019;144:476-88. [PMID: 30264887] doi:10.1002/ijc.31904 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Charles Harding, AB; Dmitriy Burmistrov, PhD; Marybeth Pompei, DPS; Francesco Pompei, PhDAffiliations: Seattle, WashingtonWoburn, MassachusettsExergen, Watertown, MassachusettsDisclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=L22-0274. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoEstimation of Breast Cancer Overdiagnosis in a U.S. Breast Screening Cohort Marc D. Ryser , Jane Lange , Lurdes Y.T. Inoue , Ellen S. O’Meara , Charlotte Gard , Diana L. Miglioretti , Jean-Luc Bulliard , Andrew F. Brouwer , E. Shelley Hwang , and Ruth B. Etzioni Estimation of Breast Cancer Overdiagnosis in a U.S. Breast Screening Cohort Per-Henrik Zahl and Karsten Juhl Jørgensen Estimation of Breast Cancer Overdiagnosis in a U.S. Breast Screening Cohort Sherwin Chiu , Benjamin Williams , Kevin Shahbazian , Michelle V. Lee Estimation of Breast Cancer Overdiagnosis in a U.S. Breast Screening Cohort Marc D. Ryser and Ruth B. Etzioni Estimation of Breast Cancer Overdiagnosis in a U.S. Breast Screening Cohort Arn Migowski Metrics October 2022Volume 175, Issue 10Page: W115KeywordsBreast cancerBreast cancer screeningCancer epidemiologyCancer screeningMammographyNatural history of diseaseOverdiagnosisPrevention, policy, and public health ePublished: 18 October 2022 Issue Published: October 2022 Copyright & PermissionsCopyright © 2022 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...